Provider Demographics
NPI:1770098501
Name:MITCHELL, YVONNE TONIE
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:TONIE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 ANSEL RD APT 925
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-4172
Mailing Address - Country:US
Mailing Address - Phone:216-703-3025
Mailing Address - Fax:
Practice Address - Street 1:1675 ANSEL RD APT 925
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-4172
Practice Address - Country:US
Practice Address - Phone:216-703-3025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0211168Medicaid